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Doug Elliott PhD RN Linda Denehy PhD BAppSc Sue Berney PhD BPhysio Jennifer A. Alison PhD MSc Dip Phty 《Australian critical care》2011,24(3):155-166
Background
Functional outcomes and health-related quality of life are important measures for survivors of a critical illness. Studies have demonstrated debilitating physical effects for a significant proportion of surviving patients, particularly those with intensive care unit-acquired weakness. Contemporary practice changes include a focus on the continuum of critical illness, with less sedation and more physical activity including mobility while in ICU, and post-ICU and post-hospitalisation activities to support optimal recovery. How to best assess the physical function of patients at different phases of their recovery and rehabilitation is therefore important.Purpose
This narrative review paper examined observational and functional assessment instruments used for assessing patients across the in-ICU, post-ICU and post-hospital continuum of critical illness.Methods
Relevant papers were identified from a search of bibliographic databases and a review of the reference list of selected articles. The clinimetric properties of physical function and HRQOL measures and their relevance and utility in ICU were reported in narrative format.Findings
The review highlighted many different instruments used to measure function in survivors of ICU including muscle strength testing, functional tests and walk tests, and patient centred outcomes such as health related quality of life. In general, the sensitivity and validity of these instruments for use with survivors of a critical illness has not yet been established.Conclusion
Based on findings from the review, screening of patients using reliable and valid instruments for ICU patients is recommended to inform both practice and future studies of interventions aimed at improving recovery and rehabilitation. 相似文献53.
Jacqui Webster PhD Sarah Asi Faletoese Su'a MHM Merina Ieremia Severine Bompoint BSc Claire Johnson BA MIPH Gavin Faeamani MPH Miraneta Vaiaso Wendy Snowdon BSc MA MIPH PhD Mary‐Anne Land MPH PhD Kathy Trieu BAppSc MPH Satu Viali Marj Moodie PhD Colin Bell BSc MSc PhD Bruce Neal MBChB MRCP PhD Mark Woodward BSc MSc PhD 《Journal of clinical hypertension (Greenwich, Conn.)》2016,18(9):884-891
This project measured population salt intake in Samoa by integrating urinary sodium analysis into the World Health Organization's (WHO's) STEPwise approach to surveillance of noncommunicable disease risk factors (STEPS). A subsample of the Samoan Ministry of Health's 2013 STEPS Survey collected 24‐hour and spot urine samples and completed questions on salt‐related behaviors. Complete urine samples were available for 293 participants. Overall, weighted mean population 24‐hour urine excretion of salt was 7.09 g (standard error 0.19) to 7.63 g (standard error 0.27) for men and 6.39 g (standard error 0.14) for women (P=.0014). Salt intake increased with body mass index (P=.0004), and people who added salt at the table had 1.5 g higher salt intakes than those who did not add salt (P=.0422). A total of 70% of the population had urinary excretion values above the 5 g/d cutoff recommended by the WHO. A reduction of 30% (2 g) would reduce average population salt intake to 5 g/d, in line with WHO recommendations. While challenging, integration of salt monitoring into STEPS provides clear logistical and cost benefits and the lessons communicated here can help inform future programs. 相似文献
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Anna Ugalde BA PhD Victoria White BA MA PhD Nicole M. Rankin BA MSc PhD Christine Paul BA PhD Catherine Segan BA PhD Sanchia Aranda RN BAppSci MN PhD Anna Wong Shee BSc BAppSc PhD Alison M. Hutchinson RN BApp Sci MBioth PhD Patricia M. Livingston BA PhD 《CA: a cancer journal for clinicians》2022,72(3):266-286
Smoking cessation reduces the risk of death, improves recovery, and reduces the risk of hospital readmission. Evidence and policy support hospital admission as an ideal time to deliver smoking-cessation interventions. However, this is not well implemented in practice. In this systematic review, the authors summarize the literature on smoking-cessation implementation strategies and evaluate their success to guide the implementation of best-practice smoking interventions into hospital settings. The CINAHL Complete, Embase, MEDLINE Complete, and PsycInfo databases were searched using terms associated with the following topics: smoking cessation, hospitals, and implementation. In total, 14,287 original records were identified and screened, resulting in 63 eligible articles from 56 studies. Data were extracted on the study characteristics, implementation strategies, and implementation outcomes. Implementation outcomes were guided by Proctor and colleagues' framework and included acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability. The findings demonstrate that studies predominantly focused on the training of staff to achieve implementation. Brief implementation approaches using a small number of implementation strategies were less successful and poorly sustained compared with well resourced and multicomponent approaches. Although brief implementation approaches may be viewed as advantageous because they are less resource-intensive, their capacity to change practice in a sustained way lacks evidence. Attempts to change clinician behavior or introduce new models of care are challenging in a short time frame, and implementation efforts should be designed for long-term success. There is a need to embrace strategic, well planned implementation approaches to embed smoking-cessation interventions into hospitals and to reap and sustain the benefits for people who smoke. 相似文献
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Mitchell Fung MD BMed MTrau Brahman Sivakumar MBBS BSci Med MS MSc FRACS Orth FAOrthA PFET Eric Jiang BSc MAppStat Mayuran Suthersan MBBS MS FRACS FAOrthA Andrew Wines MBBS FRACS Rajat Mittal BSc MBBS MMed MS PhD FRACS FAOrthA Michael Symes BAppSc Physio MBBS FRACS FAOrthA MPH 《ANZ journal of surgery》2023,93(5):1214-1219
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